Healthcare Provider Details

I. General information

NPI: 1447637731
Provider Name (Legal Business Name): ANGEL CARE HOSPICE OF ARCADIA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/06/2015
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4115 E LIVE OAK AVE
ARCADIA CA
91006
US

IV. Provider business mailing address

4115 E. LIVE OAK AVE.
ARCADIA CA
91006
US

V. Phone/Fax

Practice location:
  • Phone: 818-630-5759
  • Fax: 818-237-5413
Mailing address:
  • Phone: 818-630-5759
  • Fax: 818-237-5413

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251G00000X
TaxonomyCommunity Based Hospice Care Agency
License Number550003512
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code385H00000X
TaxonomyRespite Care
License Number
License Number StateCA

VIII. Authorized Official

Name: PARGEV GRIGORYAN
Title or Position: PRESIDENT
Credential:
Phone: 818-515-3372